Panchakarma in the Management of Grahani Roga: A Narrative Review of Clinical Evidence

Grahani Roga is described in Ayurveda in relation to impaired Agni and altered gastrointestinal function. Some clinical presentations overlap with irritable bowel syndrome (IBS), although the diagnostic constructs are not synonymous. This narrative review discusses published clinical reports on Panchakarma interventions used for Grahani Roga and clinically correlated IBS, with particular attention to Basti procedures. The available literature includes small clinical studies, comparative investigations and case reports. Takra Basti and Erandamooladi Niruha Basti have been associated with symptomatic improvement in small studies, while Piccha Basti reports describe improvements in bowel frequency, mucus, bloating and, in some recent cases, validated IBS outcome scores. Evidence for Vamana is limited, and no efficacy conclusion can be drawn from a registered Virechana trial without an available outcome report. Interpretation is constrained by small samples, heterogeneous diagnostic criteria and treatment protocols, concomitant therapies, and inconsistent outcome reporting. Reports involving inflammatory bowel disease or ulcerative colitis are considered separately from functional IBS/Grahani evidence. Current findings are hypothesis-generating rather than definitive; well-designed prospective studies with standardized interventions, validated outcomes, systematic safety reporting and longer follow-up are needed.